Teleophthalmology-Enabled Direct Vitreoretinal Surgery Listing from Community Optometric Practice: Enhanced Efficiency During Coronavirus Disease 2019, and Beyond?

The Role of Optometry in the Delivery of Eye Care via Telehealth: A Systematic Literature Review

“… 31 , 33 , 34 , 49 Other frequently utilized study designs included retrospective audits ( n = 4), 30 , 32 , 35 , 41 interobserver reliability studies ( n = 2), 29 , 37 questionnaires ( n = 3), 16 , 46 , 52 and mixed methods studies ( n = 2). 47 , 51 Less frequently utilized study designs included retrospective cohorts ( n = 2), 44 , 50 retrospective case series ( n = 2), 43 , 45 one clinical protocol, 39 a prospective case series, 42 a clinical protocol for a pilot study, 40 and a cross-sectional pre–post study 38 ( Table 1 ).…”

“…Of the 27 studies that included optometrists in the telehealth model of care, 12 studies utilized asynchronous telehealth, 29 , 35 , 36 , 38 , 43 , 44 , 47–50 , 53 , 54 where the optometrist collected clinical data from the patient in an in-person consultation that usually accompanied a referral to a teleophthalmology service. Eleven studies used synchronous telehealth, 16 , 30 , 33 , 34 , 37 , 39–42 , 51 , 52 where optometrists used video consultations to deliver primary care, including low-vision rehabilitation, consulted with general and subspecialty ophthalmologists to improve the efficiency of the referral process, and delivered comprehensive eye examinations with the assistance of an in-person technician.…”

“… 16 , 30–35 , 47 , 50 Optometrists have a role in other teleophthalmology subspecialties, including anterior and orbital disease, 45 and triaging for medical retina. 43 , 51 , 54 The role of optometrists in glaucoma management via telehealth was explored in six studies. 36 , 38 , 44 , 48 , 49 , 53 The scope of practice of optometrists reported in these publications included organizing referrals to teleophthalmology services, and facilitating videoconference calls between patients and specialists.…”

“…The role of optometrists in the remaining 16 publications is as an indirect facilitator in the delivery of telehealth, 16 , 30–35 , 43 , 45 , 47–51 , 53 , 54 primarily referring patients into a teleopthalmology service. 16 , 30–35 , 43 , 50 , 51 , 53 Other indirect roles of optometrists in telehealth services include the following: collecting clinical data required for the teleophthalmology consultation 16 , 30 , 31 , 35 , 43 , 45 , 47–50 , 54 ; providing support to the patient during the video consultation 16 , 30–34 , 45 , 51 ; suggest a management plan to accompany the referral 35 , 49 ; and initiate the management plan recommended by the ophthalmologist if the patient is referred back to the care of the optometrist. 35 , 43 , 45 , 47 , 48 …”

Digital Transformation in Ophthalmic Clinical Care During the COVID-19 Pandemic

“…Remote review of cases reduces referrals, 22,23 improves appropriateness of referrals, and can make the referral to treatment pathway more efficient, for example, patients presenting to optometry practices with a retinal detachment can be assessed by ophthalmologists and vitreo-retinal surgeons remotely and listed for surgery. 24 Capturing slitlamp images also help to monitor signs more consistently for patients who require multiple reviews.…”